170 articles - From Saturday Feb 05 2022 to Friday Feb 11 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Clin Nutr |
| Clin Gastroenterol Hepatol |
Personalized Approach to the Evaluation and Management of Gastroesophageal Reflux Disease. In patients with proven GERD, Roux-en-Y gastric bypass is an effective primary anti-reflux intervention in obese patients, and a salvage option in non-obese patients, while sleeve gastrectomy has potential to worsen GERD. 14. Candidacy for invasive anti-reflux procedures includes confirmatory evidence of pathologic GERD, exclusion of achalasia, and assessment of esophageal peristaltic function. |
| J Hepatol |
Baveno VII - Renewing consensus in portal hypertension. For each of these 9 topics, a thorough review of the medical literature was performed, and a series of consensus statements/recommendations were discussed and agreed upon. A summary of the most important conclusions/recommendations derived from the workshop is reported here. The statements are classified as unchanged, changed, and new in relation to Baveno VI. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
Systematic review with meta-analysis: loss of response and requirement of ustekinumab dose escalation in inflammatory bowel diseases. Primary responders with CD experienced LOR to ustekinumab at a risk of 21% per person-year and required dose escalation at a risk of 25% per person-year. Fifty-eight per cent of secondary non-responders with CD may benefit from dose escalation. LOR has not been well characterized in patients with UC. |
| Clin Gastroenterol Hepatol |
Duodenal Eosinophils and Mast Cells in Functional dyspepsia: A Systematic Review and Meta-Analysis of Case-Control Studies. This meta-analysis suggests a link between duodenal microinflammation and FD. However, the quality of evidence is very low, largely due to the unexplained heterogeneity and serious risk of publication bias in al comparative analyses. Thus, causality remains uncertain and further studies are required. |
| Gastrointest Endosc |
Hydrogen Peroxide Assisted Endoscopic Necrosectomy of Pancreatic Walled-Off Necrosis: A Systematic Review and Meta-Analysis. H2O2-assisted DEN of WON demonstrated excellent clinical outcomes, with minimal heterogeneity. No adverse events attributable to H2O2 were reported. Future controlled studies are warranted comparing the clinical outcomes with and without H2O2 before H2O2 use can be established in the DEN of pancreatic WON. |
| Inflamm Bowel Dis |
Inflammatory Bowel Diseases Affect the Phenotype and Disease Course of Coexisting Immune-Mediated Inflammatory Diseases: A Systematic Review With Meta-Analysis. This systematic review with meta-analysis found IBD is associated with a distinct disease phenotype among the IMIDs investigated. Our findings emphasize the importance of multidisciplinary approaches to patients with co-occurring IMIDs and IBD. |
| J Crohns Colitis |
The clinical significance of eosinophils in ulcerative colitis: a systematic review. These findings suggest that higher eosinophil levels may be associated with increased disease activity, and poorer clinical outcomes and response to therapy. Future studies are needed to determine whether a distinct eosinophil-rich UC phenotype exists and whether eosinophil-targeted therapy can alter the disease course. |
| J Hepatol |
HCC Surveillance Improves Early Detection, Curative Treatment Receipt, and Survival in Patients with Cirrhosis: A Systematic Review and Meta-Analysis. HCC surveillance is associated with improved early detection, curative treatment receipt, and survival in patients with cirrhosis, although there was heterogeneity in pooled estimates. Available data suggest HCC surveillance is of high value in patients with cirrhosis, although continued rigorous studies evaluating benefits and harms are still needed. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Prevalence of HFE-related haemochromatosis and secondary causes of hyperferritinaemia and their association with iron overload in 1059 French patients treated by venesection. Haemochromatosis is over-diagnosed and is no longer the main reason for therapeutic venesection in France. Obesity and other metabolic abnormalities are frequently associated with mild elevation of serum ferritin, the MetS is confirmed in ~50% of treated patients. There is a minimal relationship between serum ferritin and iron overload in non-p.Cys282Tyr homozygotes. Our observations raise questions about venesection indications in non-haemochromatosis patients. |
Risk of hepatocellular carcinoma in treatment-naïve chronic hepatitis B patients receiving tenofovir disoproxil fumarate versus entecavir in the United States. Among commercially insured, treatment-naïve patients with chronic hepatitis B in the United States, treatment with TDF was associated with significantly lower risk of HCC than ETV. |
The use of, and outcomes for, inflammatory bowel disease services during the Covid-19 pandemic: a nationwide observational study. There is likely a significant burden of untreated IBD in the community. Patients with IBD may experience clinical harm or protracted decreases in quality of life if care is not prioritised. |
| Am J Clin Nutr |
Assessing the validity of plasma phospholipid fatty acids as biomarkers of dairy fat intake using data from a randomized controlled intervention trial. The potential for liver fat to affect relative plasma phospholipid concentrations of C15 0 and C17 0 raises questions about their validity as biomarkers of dairy fat intake. Of the fatty acid measures tested, trans-C16 1n-7 combined with iso-C17 0, especially with adjustment of liver fat, age, and sex, may provide the most robust estimate of dairy fat consumption. Trial Registration The parent trial was registered on with the registration number NCT02663544 |
Changes in anemia and anthropometry during adolescence predict learning outcomes: findings from a 3-year longitudinal study in India. Persistent anemia, thinness and short stature during adolescence was associated with poor learning. Programs targeted at adolescents should contribute to nurturing environments that foster healthy growth and learning. |
Effects of vitamin D, omega-3 fatty acids and a simple home strength exercise program on fall prevention: the DO-HEALTH randomized clinical trial. Among generally healthy, active and vitamin D-replete older adults, supplemental omega-3 s may have a modest benefit on the incidence of total falls, whilst daily high-dose vitamin D or SHEP had no benefit. |
The energy balance model of obesity: beyond calories in, calories out. We also describe the recent history of the CIM and show how the latest "most comprehensive formulation" abandons a formerly central feature that required fat accumulation in adipose tissue to be the primary driver of positive energy balance. As such, the new CIM may be considered a special case of the more comprehensive EBM but with a narrower focus on high dietary glycemic load as the primary factor responsible for common obesity. We review data from a wide variety of studies that address the validity of each model and demonstrate that the EBM is a more robust theory of obesity than the CIM. |
Validity of continuous glucose monitoring for categorizing glycemic responses to diet: implications for use in personalized nutrition. Our data demonstrate strong concordance of CGM devices in monitoring glycemic responses and are suggest their potential use in personalized nutrition. Clinical Trial Registration NCT03479866 obtained from |
| Am J Gastroenterol |
Diagnostic Evaluation of Gastric Motor and Sensory Disorders. FDA-approved treatment options are limited and thus many patients undergo a series of empirical treatment trials that target individual symptoms, often without much benefit. This article provides updated recommendations for identifying and classifying the most common gastric motor and sensory disorders using currently accepted diagnostic tests, and provides a brief supplemental overview on treatment options. "Things sweet to taste prove in digestion sour." -Shakespeare, Richard II, 1595. |
Irritable bowel syndrome and long-term risk of cancer: a prospective cohort study among 0.5 million adults in UK Biobank. Compared with the general population, IBS does not increase the overall risk of cancer. Conversely, IBS is associated with lower risk of incident colorectal cancer and cancer specific mortality. |
Risk Factors of Clinical Relapses in Pediatric Luminal Crohn's Disease, a Retrospective Cohort Study. Relapse of pediatric Crohn's disease has decreased in the past decade. The risk of relapse is significantly associated with clinical, endoscopic, histological and laboratory variables and treatment strategies. |
Tibial Nerve Stimulation for Fecal Incontinence: The Importance of Sham. The present study by Zynczyski et al compared active PTNS to a sham control group of women with fecal incontinence. Similar to previous studies, active PTNS provided benefits to treated patients but were not different from the sham group. This study highlights the need for rigorously performed controlled studies of neuromodulation for anorectal disorders. |
Transient Lymphocytic Colitis following SARS-CoV2 mRNA vaccine. Mucosal evaluation revealed lymphocytic colitis. Review of the Vaccine Adverse Event Reporting System revealed 5 cases of microscopic colitis following the second mRNA dose. This report and VAERS cases suggest providers should consider microscopic colitis in the differential diagnosis of patients with severe, persistent diarrhea following the SARS-CoV2 mRNA vaccine. |
| Clin Gastroenterol Hepatol |
Cost effectiveness of mailed outreach programs for colorectal cancer screening: Analysis of a pragmatic, randomized trial. Mailed FIT or colonoscopy invitations are both options to improve CRC screening completion and advanced neoplasia detection, and the choice of outreach strategy may differ by a health system's willingness to pay threshold. Mailed FIT kits are less expensive than colonoscopy invitations but result in fewer months of screening compliance and advanced neoplasia detected. |
Effects of attendance to an organized fecal immunochemical test screening program on the risk of colorectal cancer: an observational cohort study. Attendance to a FIT screening program is associated with a CRC incidence reduction of 33% among men and 21% among women, and a CRC mortality reduction of 65% and 54%, respectively. |
Long-term evolution of estimated glomerular filtration rate in patients with antiviral treatment for hepatitis C virus infection. Background & aims Data regarding the long-term evolution of estimated glomerular filtration rate (eGFR) in patients receiving antiviral treatment for hepatitis C virus (HCV) are limited. Methods A total of 1987 patients with eGFR = 15 mL/min/1.73m 2 who received interferon (IFN) or direct-acting antiviral (DAA) treatment were prospectively enrolled in this cohort study. The eGFR was assessed biannually by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation from the time point of sustained virologic response (SVR with anti-HCV treatment. |
Mendelian Randomization Analysis Reveals No Causal Relationship Between Nonalcoholic Fatty Liver Disease and Severe COVID-19. There is no evidence supporting that NAFLD is a causal risk factor for severe COVID-19. Previous observational associations between NAFLD and COVID-19 are likely attributed to the correlation between NAFLD and obesity. |
New therapeutic strategies have changed the natural history of paediatric Crohn's disease: a two-decade population-based study. In parallel with the increased use of IS and anti-TNF, positive changes in the natural history of paediatric-onset CD were observed at the population-level. A decreased risk of both intestinal resection and stricturing complication were observed during the anti-TNF era. |
The Performance of AFP, AFP-3, DCP as Biomarkers for Detection of Hepatocellular Carcinoma (HCC). A Phase 3 Biomarker Study in the United States. In a prospective cohort phase 3 biomarker study, GALAD was associated with a considerable improvement in sensitivity for HCC detection but an increase in false positive results. GALAD performance was modest and not different from AFP-3 alone or HES. |
Two-step strategy, FIB-4 followed by magnetic resonance elastography, for detecting advanced fibrosis in NAFLD. The diagnostic accuracy of the two-step strategy was comparable to MRE and could reduce cost by reducing excessive MRE. Therefore, the two-step strategy could be used as a screening method in a large population. |
| Endoscopy |
Comparison of the removal ability of basket catheters for small bile duct stones impacted in the corner pocket of the lower bile duct. Robust helical eight-wire baskets with smaller inter-wire spaces at the tip may be effective for extracting corner pocket stones, while the addition of rotational motion may improve the efficacy of retrieval. |
Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy for the palliation of gastric outlet obstruction in patients with peritoneal carcinomatosis. The EUS-GE group had shorter procedure duration, length of stay, and time to chemotherapy resumption than the SGJ group. CONCLUSIONS : Although the EUS-GE group was older, with more comorbidity and advanced stages, the technical success rate was similar to SGJ and it had significantly fewer adverse events. EUS-GE is a safe and effective option for the management of malignant GOO with peritoneal carcinomatosis. |
Impact of surgical versus endoscopic management of complex nonmalignant polyps in a colorectal cancer screening program. Referring patients with complex polyps to an expert endoscopist first reduced some surgery-related deaths while substantially improving cost-effectiveness of the screening program. |
THRESHOLD EVALUATION FOR OPTIMAL NUMBER OF ENDOSCOPIC TREATMENT SESSIONS TO ACHIEVE COMPLETE ERADICATION OF BARRETT'S METAPLASIA. The current study examines a threshold of 3 EET sessions whereby majority of patients undergoing EET should achieve CE-IM. Alternative therapies and further diagnostic testing should be considered for patients who do not have significant response to EET after 3 sessions. |
| Gastroenterology |
Guselkumab for the treatment of Crohn's disease: Induction results from the Phase 2 GALAXI-1 study. At week 12, al three dose regimens of guselkumab induced greater clinical and endoscopic improvements vs placebo, with a favorable safety profile;ClinicalTrials.gov number, NCT03466411. |
Helicobacter pylori-induced RASAL2 through activation of NF-kB promotes gastric tumorigenesis via ß-catenin signaling axis. These studies uncovered a novel signaling axis of NF- |
Higher vs Standard Adalimumab Induction Dosing Regimens and 2 Maintenance Strategies: Randomized SERENE CD Trial Results. HIR was not superior to SIR, and CA and TDM maintenance strategies were similarly efficacious. Adalimumab therapy was well tolerated, and no new safety concerns were identified. (, Number NCT02065570). |
INCIDENCE OF HEPATOCELLULAR CARCINOMA IN NONALCOHOLIC FATTY LIVER DISEASE. Historically, HCC risk and targeting of surveillance programs were largely restricted to patients with cirrhosis, outside of hepatitis B infection. However, this paradigm was challenged by studies that demonstrated up to one-third of HCC in the setting of NAFLD occur in the absence of cirrhosis, raising the question if surveillance programs should be expanded to non-cirrhotic NAFLD. These studies underscored the importance of defining NAFLD subgroups with sufficiently high HCC risk to warrant HCC surveillance. |
Iron Deficiency Anemia and Hematochezia are Red Flags for Colorectal Cancer in Young Patients. Incidence of colorectal cancer (CRC) diagnosed in individuals under age 50, or young-onset colorectal cancer (YCRC), is rising. Iron deficiency anemia (IDA) and hematochezia are potential red-flag symptoms of YCRC, however there is minimal data on the magnitude of risk associated with these symptoms, and therefore mixed guidance on appropriate evaluation of these symptoms in patients under age 50. |
| Gastrointest Endosc |
Reduction of esophageal stent migration rate with a novel over-the-scope fixation device. In patients with benign or malignant gastroesophageal diseases, there was a significantly lower stent migration rate in patients managed with the stentfix OTSC system compared with those without stent fixation. The application was technically successful in al cases and no adverse events related to clip application or removal were observed. |
Reliability and Responsiveness of Endoscopic Disease Activity Assessment in Eosinophilic Esophagitis. EREFS and its modifications were reliable and responsive, and the original or expanded versions of the EREFS may be preferred in RCTs. Disease activity scored based on the worst affected area optimizes reliability and responsiveness. Funding None. |
| Gut |
FSTL1 promotes liver fibrosis by reprogramming macrophage function through modulating the intracellular function of PKM2. Macrophage FSTL1 promotes the progression of liver fibrosis by inducing M1 polarisation and inflammation based on the intracellular PKM2 reprogramming function of macrophages. |
Gut microbiota composition is associated with SARS-CoV-2 vaccine immunogenicity and adverse events. Our study has identified specific gut microbiota markers in association with improved immune response and reduced adverse events following COVID-19 vaccines. Microbiota-targeted interventions have the potential to complement effectiveness of COVID-19 vaccines. |
| Hepatology |
Core implementation strategies for improving cirrhosis care in the Veterans Health Administration. In a national cirrhosis care improvement initiative, a multi-method approach identified a core subset of successful implementation strategy combinations. This process of empirically identifying and specifying implementation strategies may be applicable to other implementation challenges in hepatology. |
Molecular and radio-pathologic spectrum between hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Our integrated view of the molecular spectrum of LCs can identify subtypes associated with transcriptomic, genomic, and radio-pathologic features, providing new mechanistic insights into the heterogeneous LC progression. |
Racial/ethnic disparities in hepatocellular carcinoma incidence and mortality rates in the United States, 1992-2018. HCC incidence and mortality rates began to decline for most groups in 2015, but persistent differences in rates continued to exist. Rates among non-Hispanic Black persons didn't decline significantly, and rates among American Indians/Alaska Natives significantly increased, suggesting greater effort is needed to reduce the HCC burden among these vulnerable groups. |
| Inflamm Bowel Dis |
Fecal Calprotectin Is a Predictor of Need for Rescue Therapy in Hospitalized Severe Colitis. Fecal calprotectin levels may serve as a useful noninvasive predictor of medical and surgical risk in individuals with UC presenting with acute severe colitis. This approach can facilitate earlier therapeutic interventions and improve outcomes. |
Impact of Biological Therapies and Tofacitinib on Real-world Work Impairment in Inflammatory Bowel Disease Patients: A Prospective Study. Work impairment in IBD patients decreased following biological therapy or tofacitinib initiation. Patients achieving clinical remission or response showed the greatest improvement, especially UC and IBD-U patients. |
Inadequate Response, Treatment Patterns, Health Care Utilization, and Associated Costs in Patients With Ulcerative Colitis: Retrospective Cohort Study Based on German Claims Data. Our study indicates a high prevalence of inadequate response to advanced therapies. Only 25% of patients showed adequate response within 12 months after therapy initiation. Frequent dose and treatment changes were observed. The economic impact of suboptimal therapy in ulcerative colitis is substantial, highlighting the ongoing need for improved treatment strategies. |
Similar Gut Bacterial Composition Between Patients With Ulcerative Colitis and Healthy Controls in a High Incidence Population: A Cross-sectional Study of the Faroe Islands IBD Cohort. The similarity in bacterial community composition and absence of the beneficial Akkermansia genus in both groups raise further questions concerning the underlying susceptibility toward inflammatory disorders within this high-risk population. Results vary widely by study design and geographic location, which speaks to the need for regionally tuned reference groups and disease-based studies on the Faroe Islands. |
Ultrasound-Tomographic Image Fusion: A Novel Imaging Technique for Follow-Up of Penetrating Complications of Crohn's Disease. We herein report the first use, to our knowledge, of computed tomography-ultrasound (US) fusion technique to follow-up Crohn's disease complications. This novel technique employs real-time reconstructed fusion of previously obtained tomographic images onto the US image software, allowing accurate bedside spatial resolution, localization, and lesion characterization by US. |
| J Crohns Colitis |
Identification of gene expression profiles associated with an increased risk of post-operative recurrence in Crohn's disease. We identify several biological pathways in the surgical specimen associated with an increased risk of disease recurrence. Integration of JAK/STAT and mitochondrial dysfunction pathways in the clinical model improved the prediction of post-operative recurrence. |
Role of nutrient-sensing receptor GPRC6A in regulating colonic group 3 innate lymphoid cells and inflamed mucosal healing. Our findings unveil a role for the nutrient-sensing receptor GPRC6A in colonic ILC3 function and identify a novel ILC3 receptor signalling pathway modulating inflamed mucosal healing. |
| J Hepatol |
Artificial intelligence predicts immune and inflammatory gene signatures directly from hepatocellular carcinoma histology. We have developed and validated AI based pathology models able to predict the activation of several immune and inflammatory genes signatures. Our approach also provides insights on the morphological features that impact the model predictions. This proof-of-concept study shows that AI based pathology could represent a novel type of biomarker that will ease the translation of our biological knowledge of HCC into clinical practice. |
Interruption of bile acid uptake by hepatocytes after acetaminophen overdose ameliorates hepatotoxicity. APAP overdose induces a breach of the blood-bile barrier which leads to futile BA cycling that causes hepatocyte death. Prevention of BA cycling may represent a therapeutic option after APAP intoxication. |
Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation. Recurrence of AIH following transplant is frequent and is associated with younger age at LT, use of mycophenolate mofetil post-LT, sex mismatch and high IgG pre-LT. We demonstrate an association between disease recurrence and impaired graft and overall survival in patients with AIH, highlighting ongoing efforts to better characterize, prevent and treat recurrent AIH. Lay abstract Recurrent autoimmune hepatitis following liver transplant is frequent and is associated with some recipient features and the type of antirejection medications. Recurrent autoimmune hepatitis negatively affects the outcome after liver transplant. |
| Liver Transpl |
Complete transition from open surgery to laparoscopy: 8-year experience with more than 500 laparoscopic living donor hepatectomies. Complete transition to laparoscopic living donor hepatectomy was possible after accumulating a significant amount of experience. Since donor morbidity can be higher in the initial period, donor selection for favorable anatomy is required for both the donor and recipient. |
Glomerular Filtration Rate Early After Liver Transplantation Independently Predicts Atherosclerotic Events. Glomerular filtration rate 6 months following LT is a strong predictor of developing atherosclerotic events. This relationship is independent of traditional CVD risk-stratification model (FRS), thus, has the potential to be incorporated into CVD risk assessment after LT but requires further validation. |
| Neurogastroenterol Motil |
Retrograde upper esophageal sphincter function… and dysfunction. The obscurity of R-UESD has recently been challenged by two large series published in the ENT literature of circumstantially demonstrated R-UESD that was resolved by botulinum toxin (BT) injection to the cricopharyngeus. The field has now further advanced with the publication in this issue of the Journal by Oude Nijhuis et al of 8 cases of R-UESD demonstrated by high-resolution impedance manometry (HRIM) with a provocative challenge of carbonated water. These individuals were also treated with BT and at 3-month follow-up had both an encouraging symptomatic response and HRIM demonstrated resolution of R-UESD. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
TEGASEROD: WHAT'S OLD IS NEW AGAIN. A., in April 2019 tegaserod was once again approved for use in IBS-C under a more restricted labeling, confining use to women under the age of 65 without heart disease or additional cardiovascular risk factors. This review summarizes the regulatory journey of tegaserod, and details the existing pharmacokinetic, physiologic, clinical, and safety data of tegaserod generated over the last two decades. The discussion also examines the future of tegaserod in the treatment of these constipation disorders, as well as its potential role in other related disorders of brain-gut interaction (DGBI). |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
Dietary macronutrients and the gut microbiome: a precision nutrition approach to improve cardiometabolic health. Furthermore, we describe how this knowledge can be integrated to develop precision-based nutritional strategies to improve bodyweight control and metabolic health in humans. Specifically, we will address that (1) insight in the role of the baseline gut microbial and metabolic phenotype in dietary intervention response may provide leads for precision-based nutritional strategies; that (2) the balance between carbohydrate and protein fermentation by the gut microbiota, as well as the site of fermentation in the colon, seems important determinants of host metabolism; and that (3) 'big data', including multiple omics and advanced modelling, are of undeniable importance in predicting (non-)response to dietary interventions. Clearly, detailed metabolic and microbial phenotyping in humans is necessary to better understand the link between diet, the gut microbiome and host metabolism, which is required to develop targeted dietary strategies and guidelines for different subgroups of the population. |
Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer. Clinical data suggest that O3FAs have differential anti-CRC activity depending on several host factors (including pretreatment blood O3FA level, ethnicity and systemic inflammatory response) and tumour characteristics (including location in the colorectum, histological phenotype (eg, conventional adenoma or serrated polyp) and molecular features (eg, microsatellite instability, cyclooxygenase expression)). Recent data also highlight the need for further investigation of the effect of O3FAs on the gut microbiota as a possible anti-CRC mechanism, when used either alone or in combination with other anti-CRC therapies. Overall, these data point towards a precision approach to using O3FAs for optimal prevention and treatment of CRC based on mechanistic understanding of host, tumour and gut microbiota factors that predict anticancer activity of O3FAs. |
| Hepatology |
| J Hepatol |
Cigarette Smoking and Liver Diseases. Importantly, smoking promotes cardiovascular disease and extra-hepatic cancers in patients with steatohepatitis and in transplanted patients. We discuss the relevance of promoting smoking cessation to improve rates of treatment response in clinical trials, fibrosis regression, risk of hepatocellular carcinoma and liver transplant outcomes. Finally, we discuss current challenges such as the referral of smokers to specialized units for smoking cessation. |
| Liver Transpl |
| Neurogastroenterol Motil |
Management of bloating. The main targets of pharmacological treatments are to improve transit and evacuation with prokinetics, to improve intestinal gas tolerance with antispasmodics and/or neuromodulators, and to modify intestinal microbiota with antibiotics. Secretagogues act by increasing intestinal secretion and decreasing visceral sensitivity and have been reported to be an effective treatment alternative for patients with bloating associated with constipation. Biofeedback therapy addressed to correct abdomino-phrenic dysynergia may be useful for patients with objective abdominal distension, and patients with bloating associated with outlet obstructed defecation may benefit from anorectal biofeedback. |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
| Liver Transpl |
| Neurogastroenterol Motil |
all remaining publications eg case reports, images of the month, etc…
| Am J Clin Nutr |
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Inflamm Bowel Dis |
| J Crohns Colitis |